Venous leg ulcers (VLUs) are the most severe complication caused by the progression of chronic venous insufficiency. They account for approximately 70–90% of all chronic leg ulcers (CLUs). A total of 1% of the Western population will suffer at some time in their lives from a VLU. Furthermore, most CLUs are VLUs, defined as chronic leg wounds that show no tendency to heal after three months of appropriate treatment or are still not fully healed at 12 months. The essential feature of VLUs is their recurrence. VLUs also significantly impact quality of life and could cause social isolation and depression. They also have a significant avoidable economic burden. It is estimated that the treatment of venous ulceration accounts for around 3% of the total expenditure on healthcare. A VLU-free world is a highly desirable aim but could be challenging to achieve with the current knowledge of the pathophysiology and diagnostic and therapeutical protocols. To decrease the incidence of VLUs, the long-term goal must be to identify high-risk patients at an early stage of chronic venous disease and initiate appropriate preventive measures. This review discusses the epidemiology, socioeconomic burden, pathophysiology, diagnosis, modes of conservative and invasive treatment, and prevention of VLUs.

Diabetic peripheral neuropathy (DPN) is present in 20–50% of cases with diabetes. The pathophysiology of DPN is not yet clear regarding hypertension (HTN). The aim of this study was to assess the association between the stages of DPN and HTN in a Greek population with diabetes. We examined 102 adults for diabetic neuropathy (DPN) from November 2020 to December 2021, using the Toronto Clinical Neuropathy Scale System (TCNSS) to categorize them into two groups (no/mild DPN versus medium/severe DPN). Ambulatory blood pressure monitoring was performed to evaluate their hypertensive status. Univariate and multivariate logistic regression analyses were performed to assess the association between the stage of DPN and HTN. The multivariate analysis, considering sex, age, and dipping status, did not show statistically significant associations between stages of HTN and DPN. However, in contrast to dippers, non-dippers had an almost four-times higher risk of developing medium-to-severe DPN (odds ratio (OR) 3.93; 95% confidence interval (CI) [1.33–11.64]); females, in contrast to males, had a 65% lower risk of developing moderate/severe DPN (OR 0.35; 95%CI [0.14–0.92]). In conclusion, our findings showed no statistically significant associations between DPN and HTN; however, dipping status, hyperglycemia, and female sex were shown to play a role in the pathophysiology of DPN.

Background: Telemedicine is increasingly used in several fields of healthcare, including vascular medicine. This study aimed to investigate the views of experts and propose clinical practice recommendations on the possible applications of telemedicine in vascular medicine. Methods: A clinical guidance group proposed a set of 67 clinical practice recommendations based on the synthesis of current evidence and expert opinion. The Telemedicine Vascular Medicine Working Group included 32 experts from Europe evaluating the appropriateness of each clinical practice recommendation based on published RAND/UCLA methodology in two rounds. Results: In the first round, 60.9% of clinical practice recommendations were rated as appropriate, 35.9% as uncertain, and 3.1% as inappropriate. The strongest agreement (a median value of 10) was reached on statements regarding the usefulness of telemedicine during the 2019 coronavirus disease (COVID-19) pandemic, its usefulness for geographical areas that are difficult to access, and the superiority of video calls compared to phone calls only. The lowest degree of agreement (a median value of 2) was reported on statements regarding the utility of telemedicine being limited to the COVID-19 pandemic and regarding the applicability of teleconsultation in the diagnosis and management of abdominal aortic aneurysm. In the second round, 11 statements were re-evaluated to reduce variability. Conclusions: This study highlights the levels of agreement and the points that raise concern on the use of telemedicine in vascular medicine. It emphasizes the need for further clarification on various issues, including infrastructure, logistics, and legislation.

Objective: The Mediterranean diet is considered a cornerstone in the regulation of the person with dyslipidemia and diabetes mellitus. The aim of the study is to record the eating habits of patients with dyslipidemia and type 2 diabetes mellitus and to correlate these habits with their regulation. Design and method: This study involved 948 patients (490 men and 458 women with an average age of 61.6±7 years). A registration questionnaire was used for their demographic, somatometric data, their eating habits, their medication and patients’ compliance with them was reassessed with a review after six months. Results: The duration of dyslipidemia was 12.7±14.2 years and DM2 was 12.8±14.4 years. The mean value of glycosylated hemoglobin was (HbA1c) 6.73±2.55%, with 57.1% of patients having HbA1c less than 7%. The body mass index (BMI) was 32.6±6.85 in both sexes (p = 0.440). 66.8% of patients were overweight, and obese with women having higher rates. 87.1% of patients consume breakfast, fruits more than 7 times a week consume 33.1%, vegetables at least 2 times 53.6%, meat 2 times 42%, fish 1 time 46.8%, legumes 65%, chicken 2 times 29.1% and sweets consume 16.6% of patients. A positive association with the regulation of dyslipidemia and DM2 is shown by the consumption of balanced breakfast (p = 0.001) and the presence of 2 main meals in the daily schedule (p = 0.008). The high consumption of junk food (p = 0.009), the consumption of soft drinks (p = 0.056) and the consumption of sweets (p< 0.001) had a negative impact. 27% of patients were in higher education, 43.5% in secondary education, and 31.5% in basic education. Insufficient control of dyslipidemia was in 60,5% of patients. The prevalence of metabolic syndrome was found to be less in those who followed the Mediterranean diet. Conclusions: The eating habits of people with dyslipidemia and DM2 affect their regulation having a positive effect especially on glycemic regulation. The adoption of the Mediterranean diet is accompanied by a reduction in the risk of developing metabolic syndrome.